Provider Demographics
NPI:1053561944
Name:NICHOLSON, KIRK E (LPC)
Entity type:Individual
Prefix:MR
First Name:KIRK
Middle Name:E
Last Name:NICHOLSON
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 E MAIN ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-1333
Mailing Address - Country:US
Mailing Address - Phone:405-801-2488
Mailing Address - Fax:405-801-2588
Practice Address - Street 1:210 E MAIN ST
Practice Address - Street 2:SUITE 210
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-1333
Practice Address - Country:US
Practice Address - Phone:405-801-2488
Practice Address - Fax:405-801-2588
Is Sole Proprietor?:No
Enumeration Date:2008-09-26
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1908101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor